Provider Demographics
NPI:1881834059
Name:WAHLHEIM, DEANNA (LAMFT)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:WAHLHEIM
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-1117
Mailing Address - Country:US
Mailing Address - Phone:480-213-6058
Mailing Address - Fax:
Practice Address - Street 1:310 W HOLLY ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1117
Practice Address - Country:US
Practice Address - Phone:480-213-6058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10245106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist